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From: Tom Klassen
Date: 10/10/01
Time: 10:35:24 AM
Remote Name: 130.63.75.220
Below are the questions I asked in the survey about attitudes of stuttering and people who stutter.
Unfortunately, some of the formatting and fonts have been lost in posting the questions.
cheers, Tom
Please select one friend or family member who stutters.
Please write the person's first name here: ____________________________ . The name is required only to code your answers and will be kept confidential.
All questions below refer to this individual.
1. How long have you known this individual (check ONE)?
[ ] less than three months [ ] between three months and less than 2 years [ ] between 2 years and less than 10 years [ ] more than 10 years
2. How would you describe this individual's stuttering to someone who has never met him/her before (check ONE only)?
[ ] a mild stutterer who stutters once in a while [ ] a moderate stutterer who stutters some of the time [ ] a severe stutterer who stutters nearly all the time
Questions 3 and 4 below ask about the frequency of stuttering. Frequency is the number of times stuttering (repeated sounds or words, blockages in speech, etc.) occur, not their severity.
3. Do you think the individual stutters more frequently in some situations than others?
[ ] no [ ] yes
If YES (check ONE or MORE): [ ] in large groups [ ] in small groups [ ] one-on-one [ ] on the telephone
4. Do you think stuttering is more frequent (check ONE or MORE)?
[ ] at the beginning of sentences [ ] as the end of sentences [ ] on particular words [ ] no pattern is noticeable
Questions 5 and 6 ask about the severity of stuttering. Severity is the seriousness of the stuttering, including its length, and behaviours such as avoiding eye contact, grimaces, etc.
5. Do you think the individual stutters more severely in some situations than others?
[ ] no [ ] yes
If YES (check ONE or MORE): [ ] in large groups [ ] in small groups [ ] one-on-one [ ] on the telephone
6. Do you think the stuttering is more severe (check ONE or MORE)?
[ ] at the beginning of sentences [ ] as the end of sentences [ ] on particular words [ ] no pattern is noticeable
7. Have you ever discussed the individual's stuttering with him/her?
[ ] yes [ ] no
If YES, who initiated the conversation(s) (check ONE only)?
[ ] I did [ ] the stutterer
8. Have you ever discussed the individual's stuttering with others?
[ ] no [ ] yes
If YES, with whom (check ONE or MORE)?
[ ] your family [ ] your friends [ ] your colleagues [ ] others, please describe:_________________________________________
9. Have you ever felt that the individual wanted you to finish a word for him/her that he/she was having difficulty saying?
[ ] no [ ] yes
10. Have you ever finished, or tried to finish, words for the individual when he/she was stuttering?
[ ] yes [ ] no
If YES, what was your primary reason for finishing words (check ONE only)?
[ ] I felt embarrassed for myself [ ] I felt embarrassed for the stutterer [ ] I felt sorry for the stutterer [ ] I wanted the conversation to continue [ ] I felt other listeners wanted the conversation to continue [ ] other, please describe: ___________________________________________ ___________________________________________
11. What do you think is the primary feeling of the individual when he/she stutters when speaking to you (check ONE only)?
[ ] frustration [ ] impatience [ ] anger [ ] acceptance [ ] no particular feeling [ ] other, please describe:______________________________________________ ______________________________________________
12. How would you rate the individual's speaking abilities on the scale below (circle ONE number)? A rating of 1 means that his/her speech is perfectly normal (like the weather being hot in July), while a rating of 9 means the speech is very abnormal (like having snow in July).
1------2------3------4------5------6------7------8------9 normal abnormal
13. Would you like to receive a copy of the findings of this study?
[ ] yes [ ] no
If YES, please enclose a separate piece of paper with your mailing address.
14. Based on your experiences, what suggestions or advice do you have for non-stutterers when they communicate with people who stutter?